When the management of obesity takes on the appearance of haute couture – 05/07/2018

Sometimes the clbadical surgery of obesity is impossible . This is when a new technique is offered to patients: bariatric endoscopy. It is actually about reducing the size of the stomach via sutures. A work at the edge of sewing made in only 10 establishments in France, including the University Hospital of Angers. Report.

Steve and Jean-Jacques were both born in 1969. Both suffer from morbid obesity but also from heart problems (double infarction for one and cardiac arrhythmia for the other) preventing them from undergoing surgery.

That is why, last June 11th, they underwent an endoscopic sleeve gastroplasty (also called bariatric endoscopy) at the University Hospital of Angers. Behind this name hides a technique that reduces the volume of the stomach from within. In fact, this procedure is done using an endoscope, an optical instrument with a "mini sewing machine" and introduced into the esophagus into the stomach. No incision therefore.

The goal here is to suture the stomach to fold on itself and make it lose volume. " It's a bit like making a rugby ball a simple tube ," commented Drs. Anne Olivier and Arthur Berger of the Hepato-gastroenterology department of the University Hospital of Angers, who each realized one of the operations. " Thus, only 10 to 20% of the initial gastric volume is preserved . »Total duration of the operation: less than two hours. As for the duration of hospitalization post-operative, it is established of 2 days.

An alternative to the clbadical surgery

The finality of this sleeve is not to replace the conventional surgical techniques for the management of obesity (by gastric pbad for example), but rather to offer an alternative to patients who are too risky to be operated on. Indeed, with this technique, " the complications are of the order of 0 to 2% ," comments Dr. Berger. " We hope to make patients lose 20% of their weight in one year, which will also improve their cardiovascular health, their diabetes … "

And the results are promising. Three weeks after the operation, Steve has already lost 7kg (out of the 140 before the operation). For his part, Jean-Jacques lost 9 (out of the 165 he presented). " I feel less hunger and satiety comes faster ," rejoices the first. " I eat 20% less. I feel more fit … "

Jean-Jacques is less categorical. He does not feel that he is satiated. In fact it is his body that sends him signals unpleasant (flatulence, gastric acidity …) to make him understand that he has enough. Side physical abilities, he feels more tired. A state that he puts on the account " heat and a corpulence greater than that of his comrade .

But overall, both men are fine. They will be followed in the long term physically and nutritionally. In this regard, note that during the weeks following their operation, their diet was exclusively liquid. Since then, they've switched to mixed dishes and should soon return to a normal, solid diet … that they look forward to.